Exploring Strategies to Promote Frequent Testing among MSM

探索促进MSM频繁检测的策略

• 批准号: 8658563
• 负责人: Theodorus G.M. Sandfort
• 金额: $ 23.77万
• 依托单位: NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-23 至 2016-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8658563
• 关键词: AIDS diagnosis; AIDS prevention; Acquired Immunodeficiency Syndrome; Acute; Address; Advisory Committees; Affect; Age; Anti-Retroviral Agents; Behavioral; Centers for Disease Control and Prevention (U.S.); Clinical; Collaborations; Communities; Community Healthcare; Cost-Benefit Analysis; Development; Diagnosis; Early Diagnosis; Early identification; Effectiveness; Financial compensation; Frequencies; Goals; HIV; HIV Infections; HIV diagnosis; Health; Healthcare; Healthcare Systems; High Prevalence; Human immunodeficiency virus test; Incidence; Individual; Infection; Intervention; Interview; Knowledge; Lead; Mental Health; Minority; New York; New York City; Newly Diagnosed; Outcome Study; Persons; Policies; Population; Prevalence; Prevention approach; Prevention strategy; Qualitative Research; Recommendation; Research; Research Project Grants; Risk; Risk Behaviors; Risk-Taking; Sampling; Security; Sex Behavior; Subgroup; Test Result; Testing; Time; Unsafe Sex; Viral; Viral Load result; Woman; aged; antiretroviral therapy; base; disorder prevention; effective intervention; high risk; informant; men; men who have sex with men; multi-component intervention; prevent; public health relevance; safer sex; screening; sex; sexual risk taking; sexually active; tool; transmission process

DESCRIPTION (provided by applicant): As a crucial component of the "HIV Treatment as Prevention" approach, HIV testing has become a major tool in reducing HIV transmission. Persons who become aware of their HIV infection tend to reduce their sexual risk practices. Early identification facilitates more timely viral suppression, minimizing onward HIV transmission, including during the acute period when viral load tends to be high. While recent policies promote the routine offer of testing, additional strategies are needed to promote frequent testing for high-prevalence, high-incidence populations such as men who have sex with men (MSM). MSM are the largest risk group in the US and the only group in which new infections are increasing. MSM test more often than men who have sex with women. But relatively few MSM test as often as recommended by CDC - two to four times per year. More widespread frequent testing among MSM has ten potential to reduce the transmission of HIV in this population. While a small group of sexually active MSM have never tested for HIV, others test infrequently or delay testing until becoming symptomatic with AIDS. At the same time, a subgroup of MSM who test frequently have high levels of sexual risk; while unprotected sex can motivate HIV testing, testing confers a false sense of security and may lead to greater risk-taking. Research has identified individual and structural determinants for HIV testing in general; frequent HIV testing is, however, likely to respond to a different set of determinants. It is also ot known to what extent frequent testing is feasible and for which groups of sexually-active MSM. The few evaluated interventions that promote HIV testing in MSM have not addressed HIV testing that is frequent. In order to develop strategies that can promote frequent testing while reinforcing safer sex practices and avoiding risk compensation, an in-depth understanding is needed of the current HIV testing practices of MSM, how testing relates to sexual risk-taking, and the factors that promote or impede frequent HIV testing. In order to accomplish our goals, we propose a two-year developmental research project in which we will (1) conduct in-depth interviews with a purposive sample of 72 MSM in NYC, 18 to 39 years old, from diverse sociocultural backgrounds and with a range of HIV testing frequencies, and with 10 key informants; (2) use findings to identify potentially effective strategies to promote frequent testig for sexually- active MSM who never test, test infrequently, or test regularly but at less than optimal frequency, that simultaneously prevent frequent testing from becoming an alternative to safer sex practices; and (3) establish an NYC MSM HIV Testing Task Force of diverse stakeholders to assist in implementing the research, analyzing findings, and identifying prevention strategies. This project is a collaboration between the NYC Department of Health and Mental Hygiene and the HIV Center for Clinical and Behavioral Studies. Based on the study outcomes, we plan to develop, implement and evaluate a multi-component intervention to promote frequent HIV testing among diverse MSM in NYC.

描述（由申请人提供）：作为“预防HIV治疗”方法的关键组成部分，HIV测试已成为减少HIV传播的主要工具。意识到艾滋病毒感染的人倾向于减少他们的性风险习惯。早期鉴定促进了更及时的病毒抑制，从而最大程度地减少了向前的HIV传播，包括在病毒负荷趋于较高的急性时期。尽管最近的政策促进了常规的测试提议，但仍需要其他策略来促进对高偏见，高累积人群的频繁测试，例如与男性发生性关系的男性（MSM）。 MSM是美国最大的风险群体，也是唯一增加新感染的人群。 MSM测试比与女性发生性关系的男性更频繁。但是，按照CDC的建议，相对较少的MSM测试 - 每年两到四次。在MSM中，更广泛的经常测试具有十种潜在的潜力，可以减少该人群中HIV的传播。虽然一小群性活跃的MSM从未对HIV进行测试，但其他人则很少测试或延迟测试直到对AIDS进行症状。同时，经常测试的MSM亚组具有很高的性风险；尽管无保护的性行为可以激发艾滋病毒测试，但测试却赋予了错误的安全感，并可能导致更大的冒险。研究已经确定了艾滋病毒测试的个体和结构决定因素。但是，频繁的艾滋病毒测试可能会对不同的决定因素做出反应。还知道，频繁测试在多大程度上是可行的，并且具有性活性MSM的群体。在MSM中促进HIV测试的少数评估干预措施尚未解决经常进行的HIV测试。为了制定可以促进经常进行测试的策略，同时加强更安全的性行为并避免风险补偿，需要对当前MSM的HIV测试实践有深入的了解，测试与性冒险的关系以及促进或促进常见的HIV艾滋病毒测试的因素。为了实现我们的目标，我们提出了一个为期两年的发展研究项目，我们将（1）从纽约市的72 MSM进行深入的访谈，18至39岁，来自不同的社会文化背景，以及一系列的HIV测试频率，以及10个关键的线人； （2）使用发现来识别潜在的有效策略，以促进从不经常测试，测试或定期测试但以不到最佳频率测试的性活性MSM的频繁测试，但同时阻止频繁的测试成为更安全的性实践的替代方案； （3）建立了不同利益相关者的NYC MSM HIV测试工作组，以协助实施研究，分析发现并确定预防策略。该项目是纽约市卫生与精神卫生部与艾滋病毒临床和行为研究中心之间的合作。根据研究结果，我们计划开发，实施和评估多组分干预措施，以促进纽约市各种MSM之间频繁的HIV测试。